International Group Preparing Guidelines for Antiemesis Agents

International Group Preparing Guidelines for Antiemesis Agents

NEW YORKMembers of eight major oncologic organizations are working
together to produce a set of uniform guidelines for the prevention and control
of nausea and vomiting in cancer patients undergoing chemotherapy.

The ad hoc international group is working to reconcile the six sets of
guidelines already issued by various professional organizations, according to
Richard Gralla, MD, associate director and professor of medicine, Herbert
Irving Comprehensive Cancer Center of Columbia University College of Medicine.

Broad Collaboration

The collaboration includes representatives of oncology nursing, pharmacy, and medical oncology, as well as of the Multinational
Society for Supportive Care in Cancer, Dr. Gralla said during an international
teleconference for health professionals sponsored by the European Association
for Cancer Education and Cancer Care, Inc.

Nurses’ Role in Antiemesis

Proper management of nausea and vomiting requires in-depth
knowledge of both risk factors and available treatments, said Jackie Green, RGN,
lead cancer nurse and senior nurse at the Hematology and Cancer Services, Kings
College Hospital NHS Trust Medical Care Group, London. She emphasized that a
personalized, detailed, multidimensional assessment of each patient is needed
to tailor an effective treatment plan.

"Nurses play the key role in the multidisciplinary team
because of their expertise in assessment and patient education," Dr.
Richard Gralla said. He added that good communication among team members is
crucial to providing the best possible treatment for each patient.

The international collaboration on guidelines aims to help in
this effort, he said. The group hopes that its efforts will result in simple,
clear tools such as standing orders and easy-to-use forms that will ease the
ordering of appropriate medications and assist nurses in administering them and
in educating patients and family members to use them correctly.

Dr. Gralla is one of about 20 individuals from the United States, Canada,
the United Kingdom, and Europe involved in the guidelines project. He said that
preliminary results have been presented at several meetings in the United
States and Europe, with the final document slated for submission for publication later this year.

When the guidelines are finalized, the group hopes to make them easily
available in such forms as laminated cards and files that can be downloaded
from the Internet.

Different countries now follow varying guidelines for prevention and
treatment of nausea and vomiting, although studies point to a single set of
effective approaches. The dosages of various agents currently being prescribed
vary widely, he observed. In addition, studies show that even existing
guidelines are often not followed.